President, CarePartners of Connecticut

Company: Tufts Health Plan
Location: Wethersfield
Posted on: January 17, 2020

Job Description:

JOB DESCRIPTION

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS

Develop the vision and strategies for establishing, differentiating and growing CPCT to be a market leading Medicare Advantage plan. Collaborate with THP leaders in marketing, product, network management, risk adjustment, population health, operations and quality to develop plans to meet annual and long term growth and performance goals for membership growth, financial performance, and quality and member satisfaction.

Responsible for direct reports to include the in-market sales and growth team as well as the CPCT Medical Director. Matrixed relationships with market staff to include: network contracting, provider performance management, care management, THP leaders of shared services to CPCT including: Marketing, Sales Support, Product Strategy, Risk Adjustment. Population Health, Operations, Compliance, Actuarial and Finance

Build, maintain and utilize strong matrix relationships with THP leaders in all key functions to develop and oversee execution of plans to achieve performance targets.

Develop and manage the execution of sales strategies, plans and activities that drive membership growth/market share. Lead the in-market sales function to achieve sales goals through broker and direct sales activities. Collaborate with THP sales leadership to ensure effective sales support and alignment of activities to meet growth targets.

Define objectives for marketing and promotion to establish the CPCT brand, promote the plan, and generate leads to support the achievement of growth targets. Collaborate with THP marketing leadership to develop and implement multi-channel marketing plans including digital, mass media, community and provider.

Define product strategies to enable membership growth and earnings performance. Collaborate with THP leadership to assess, develop and implement new or refined products, plans, and services. Collaborate with THP leaders in product and actuarial to develop the annual CMS bids ensuring products are competitive, differentiated and support the achievement of membership and earnings goals.

Direct and collaborate with the CPCT Medical Director to define the strategies needed to meet medical cost targets, manage utilization and produce high quality outcomes. Collaborate with THP healthcare services leaders, Hartford HealthCare clinical leaders and other providers to develop and implement plans to effectively manage care, cost and quality.

Define the overall strategy for the provider network to enable membership growth and deliver high quality cost effective care. Define objectives for contract structures, payment methods and incentives. Collaborate with THP network contracting and performance management leadership to develop contracts and networks and maintain and manage network performance.

Define objectives for the management of CMS risk adjusted revenue, operations and quality. Collaborate with THP leadership in these functions to develop, implement and oversee plans to meet performance targets.

Collaborate with THP compliance to ensure plan compliance with CMS regulations. Oversee in- market sales and broker performance to meet CMS regulations.

Oversee health plan financial performance and collaborate with CPCT and THP leaders to devise and implement plans to improve results to meet targets. Develop and manage the annual financial plan and annual administrative expense budget to meet operating performance targets.

Represent CPCT with the public and with local groups and associations. Develop and nurture relationships with key external stakeholders including; providers, regulators, community influencers, brokers and employers.

Oversee financial, quality, medical cost and operational performance and report results to Board of Directors. Collaborate with HHC and THP leaders to identify and address service, support and operational performance issues

REQUIREMENTS

EDUCATION:

* Bachelor's degree required. Master's degree in business, health administration, or a related field preferred

EXPERIENCE:

* 15+ years of health plan leadership experience, including extensive experience specific to Medicare Advantage.

* A history of business ownership roles and a track record for meeting financial and business goals. Prior P&L responsibility

* Experience establishing and growing a health plan. Understands sales and marketing in a direct to consumer health plan and can leverage to develop strategies to grow membership

SKILL REQUIREMENTS: (Include interpersonal skills)

* Ability to lead and influence across functions in a highly matrixed organization. Savvy about managing competing interests and priorities in a shared services environment.

* Leadership presence and style that inspires confidence, builds and maintains successful working relationships and motivates others. Credible market facing leader with well-developed relationship skills

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS:

* The president will spend the majority of time in the Connecticut market. Frequent travel around the state of Connecticut will be required.

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!

Tufts Health Plan is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here. If you d like more information on your EEO rights under the law, please click here.

Keywords: Tufts Health Plan, New England , President, CarePartners of Connecticut, Executive , Wethersfield, Northeast